Erratum to: Echo Calling Narcissus: What Exceeds the Gaze of Clinical Ethics Consultation? Content Type Journal Article Pages 171-171 DOI 10.1007/s10730-010-9132-7 Authors Jeffrey P. Bishop, Saint Louis University Tenet Chair of Health Care Ethics, Albert Gnaegi Center for Health Care Ethics Salus Center, Room 527, 3545 Lafayette Ave St. Louis MO 63104-1314 USA Joseph B. Fanning, Vanderbilt University Center for Biomedical Ethics and Society 2525 West End Ave., 4th Floor, Suite 400 Nashville TN 37203 USA Mark J. Bliton, (...) Vanderbilt University Center for Biomedical Ethics and Society 2525 West End Ave., 4th Floor, Suite 400 Nashville TN 37203 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 22 Journal Issue Volume 22, Number 2. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:248 HISTORY OF PHILOSOPHY be taken from a philosophical point of view. Since it is not certain whether the author of the Prolegomena was or was not a Christian (p. xlix), "god" should not be capitalized, and the translation of T&~ia 5~l~ttovo'f~l~taTa as "God's creation" at IV. 15. 6 is actually misleading. Moreover, for no apparent reason, 0~oX07tz6gis translated as "metaphysical" in the first four chapters, but as "theological" (...) thereafter. Inaccuracies are very few indeed. "Ungrateful" is peculiar for o~5~5t• at I. 2. 25, and so is "adapted state" for ~to~tTe[a~ ~no~ae0g at I. 5.35; X. 26. 38, 40, and 44; at II. 10. 11, there is no need to translate o~Te&0t~6)g bu~yovxctL as "they do not aim at accurate expression," and on p. 32, line 1, "as yet" is not in the Greek of the Prolegomena, although it should have been, if the Anonymous had quoted correctly from Plato, Phaedrus 229 E. But this is trifling criticism of a work which leaves nothing to be desired in any other respect, and which displays the same high qualities of scholarship which we have come to expect of the author on the basis of his earlier achievements. MARTIN OSTWALI) Swarthmore College The Fountain of Life (Fons Vitae). By Solomon ibn Gabirol (Avicebron). Specially abridged edition, translated from the Latin by Harry E. Wedeck, with an Introduction by Theodore E. James. (New York: Philosophical Library, 1962. Unpaged introduction, 133 pp. $4.75.) The romance of the nineteenth-century discovery, by Salomon Munk, that "Avicebron's" Fons Vitae, a major source of neoplatonic thought in the thirteenth and fourteenth centuries, was actually the work of the eleventhcentury Hispano-Jewish poet, Solomon ibn Gabirol, and has often been retold. It is, indeed, a remarkable story. Perhaps its most noteworthy feature is that it reveals how closely alike Muslim, Jewish, and Christian philosophers were; by implication, then, it indicates that theological considerations were of less importance in medieval philosophy than is suggested by most historical accounts. Although the story of The Fountain of Lqe has now become an oft-told tale, the work itself has never been available in English dress. The present edition remedies this situation in part. It presents Tract III of the original text, a section dealing with the existence of simple spiritual substances. Harry Wedeck's translation is lucid and readable. Theodore E. James's introduction is useful for the beginning student but too elementary to be of much use to a more advanced reader. It is good that there is now this much to recommend to our students; we may hope that the day will come when BOOK REVIEWS 249 larger sections of the work will be translated-preferably not from the Latin, but from the Arabic original. JOSEPHL. B~u Columbia University Commentary on the Metaphysics of Aristotle. By St. Thomas Aquinas. Trans. by John P. Rowan. (Chicago, Illinois: Henry Regnery Company, 1961. Pp. xxiii + 955.2 vols., boxed, $25.00.) Generally speaking, the two Summae of St. Thomas, long available in English translation, contain all that is most personal and most profound in his philosophical thought. Nonetheless, it is quite impossible to get a fully adequate conception of St. Thomas' place in the history of western thought from a consideration of his theological writings alone. Hence, by translating St. Thomas' Commentary on the Metaphysics of Aristotle into English, Professor J. P. Rowan has provided the non-Latin reading student of the history of philosophy an invaluable service. For it is in his r61e as Aristotelian commentator that we see St. Thomas creating for the Schoolmen a version of Aristotle which served to render the Stagirite's thought into terms which became fundamental to the philosophical defense of Christianity. Further, by keeping in mind the fully-developed notions of St. Thomas on the existence of God and the nature of being as these are given us to understand in the Summae, the reader becomes better enabled, by a critical reading of Thomas' Commentary, to grasp the sense in which the Saint's theological writings are said by his enthusiasts to represent a "completing" and "perfecting" of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:248 HISTORY OF PHILOSOPHY be taken from a philosophical point of view. Since it is not certain whether the author of the Prolegomena was or was not a Christian (p. xlix), "god" should not be capitalized, and the translation of T&~ia 5~l~ttovo'f~l~taTa as "God's creation" at IV. 15. 6 is actually misleading. Moreover, for no apparent reason, 0~oX07tz6gis translated as "metaphysical" in the first four chapters, but as "theological" (...) thereafter. Inaccuracies are very few indeed. "Ungrateful" is peculiar for o~5~5t• at I. 2. 25, and so is "adapted state" for ~to~tTe[a~ ~no~ae0g at I. 5.35; X. 26. 38, 40, and 44; at II. 10. 11, there is no need to translate o~Te&0t~6)g bu~yovxctL as "they do not aim at accurate expression," and on p. 32, line 1, "as yet" is not in the Greek of the Prolegomena, although it should have been, if the Anonymous had quoted correctly from Plato, Phaedrus 229 E. But this is trifling criticism of a work which leaves nothing to be desired in any other respect, and which displays the same high qualities of scholarship which we have come to expect of the author on the basis of his earlier achievements. MARTIN OSTWALI) Swarthmore College The Fountain of Life (Fons Vitae). By Solomon ibn Gabirol (Avicebron). Specially abridged edition, translated from the Latin by Harry E. Wedeck, with an Introduction by Theodore E. James. (New York: Philosophical Library, 1962. Unpaged introduction, 133 pp. $4.75.) The romance of the nineteenth-century discovery, by Salomon Munk, that "Avicebron's" Fons Vitae, a major source of neoplatonic thought in the thirteenth and fourteenth centuries, was actually the work of the eleventhcentury Hispano-Jewish poet, Solomon ibn Gabirol, and has often been retold. It is, indeed, a remarkable story. Perhaps its most noteworthy feature is that it reveals how closely alike Muslim, Jewish, and Christian philosophers were; by implication, then, it indicates that theological considerations were of less importance in medieval philosophy than is suggested by most historical accounts. Although the story of The Fountain of Lqe has now become an oft-told tale, the work itself has never been available in English dress. The present edition remedies this situation in part. It presents Tract III of the original text, a section dealing with the existence of simple spiritual substances. Harry Wedeck's translation is lucid and readable. Theodore E. James's introduction is useful for the beginning student but too elementary to be of much use to a more advanced reader. It is good that there is now this much to recommend to our students; we may hope that the day will come when BOOK REVIEWS 249 larger sections of the work will be translated-preferably not from the Latin, but from the Arabic original. JOSEPHL. B~u Columbia University Commentary on the Metaphysics of Aristotle. By St. Thomas Aquinas. Trans. by John P. Rowan. (Chicago, Illinois: Henry Regnery Company, 1961. Pp. xxiii + 955.2 vols., boxed, $25.00.) Generally speaking, the two Summae of St. Thomas, long available in English translation, contain all that is most personal and most profound in his philosophical thought. Nonetheless, it is quite impossible to get a fully adequate conception of St. Thomas' place in the history of western thought from a consideration of his theological writings alone. Hence, by translating St. Thomas' Commentary on the Metaphysics of Aristotle into English, Professor J. P. Rowan has provided the non-Latin reading student of the history of philosophy an invaluable service. For it is in his r61e as Aristotelian commentator that we see St. Thomas creating for the Schoolmen a version of Aristotle which served to render the Stagirite's thought into terms which became fundamental to the philosophical defense of Christianity. Further, by keeping in mind the fully-developed notions of St. Thomas on the existence of God and the nature of being as these are given us to understand in the Summae, the reader becomes better enabled, by a critical reading of Thomas' Commentary, to grasp the sense in which the Saint's theological writings are said by his enthusiasts to represent a "completing" and "perfecting" of... (shrink)

Approaches to clinical ethics dilemmas that rely on basic principles or rules are difficult to apply because of vagueness and conflict among basic values. In response, casuistry rejects the use of basic values, and specification produces a large set of specified rules that are presumably easily applicable. Balancing is a method employed to weigh the relative importance of different and conflicting values in application. We argue against casuistry and specification, claiming that balancing is superior partly because it most clearly exhibits (...) the reasoning behind moral decision-making. Hence, balancing may be most effective in teaching bioethics to medical professionals. (shrink)

Researchers designing a clinical trial may be aware of disputed evidence of serious risks from previous studies. These researchers must decide whether and how to describe these risks in their model informed consent document. They have an ethical obligation to provide fully informed consent, but does this obligation include notice of controversial evidence? With ACCORD as an example, we describe a framework and criteria that make clear the conditions requiring inclusion of important controversial risks. The ACCORD model consent document did (...) not include notice of prior trials with excess death. We develop and explain a new standard labeled risk in equipoise. We argue that our approach provides an optimal level of integrity to protect the informational needs of the reasonable volunteers who agree to participate in clinical trials. We suggest language to be used in a model consent document and the informed consent discussion when such controversial evidence exists. (shrink)

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows (...) proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)

Clinical ethics consultants should show bold moral courage in discharging their duties to patients, families, and healthcare providers. Given the corrosive impact on trust, and on the appropriate d...

As currently practiced, the use of continuous sedation until death (CSD) is controlled by clinicians in a way that may deny patients a key choice in controlling their dying process. Ethical guidelines from the American Medical Association and the American Academy of Pain Medicine describe CSD as a “last resort,” and a position statement from the American Academy of Hospice and Palliative Medicine describe it as “an intervention reserved for extreme situations.” Accordingly, patients must progress to unremitting pain and suffering (...) and reach a last-resort stage before the option to pursue CSD is considered. Alternatively, we present and defend a new guideline in which decisionally capable, terminally ill patients who have a life expectancy of less than six months may request CSD before being subjected to the refractory suffering of a treatment of “last resort.”. (shrink)

Neil Levy offers the most prominent moral principles that are specifically and exclusively designed to apply to neuroethics. His two closely related principles, labeled as versions of the ethical parity principle , are intended to resolve moral concerns about neurological modification and enhancement [1]. Though EPP is appealing and potentially illuminating, we reject the first version and substantially modify the second. Since his first principle, called EPP , is dependent on the contention that the mind literally extends into external props (...) such as paper notebooks and electronic devices, we begin with an examination of the extended mind hypothesis and its use in Levy’s EPP . We argue against reliance on EMH as support for EPP . We turn to his second principle, EPP , which is not dependent on EMH but is tied to the acceptable claim that the mind is embedded in, because dependent on, external props. As a result of our critique of EPP , we develop a modified version of EPP , which we argue is more acceptable than Levy’s principle. Finally, we evaluate the applicability of our version of EPP. (shrink)

Some bioethicists have argued in favor of a sliding scale notion of competence, paternalistically requiring greater competence in relation to more significant risk. I argue against a sliding scale notion, taking issue with the positions of Allen E. Buchanan and Dan W. Brock, Ian Wilkes, and Joel Feinberg. Rejecting arguments that a sliding scale is supported by legal cases, by ordinary usage, and by fallible judgments about competence, I argue in favor of greater evidence of competence when risk is greater. (...) Two clinical cases are examined, both involving amputation, to show that my fixed concept of competence, with a requirement of clearer evidence of competence when risk is high, better accounts for good moral decisions in bioethics. (shrink)

Lukas J. Meier et al. offer the promise of a pathway for resolving clinical bioethical problems using an artificial intelligence interface. The ultimate goal, we assume, is...

Susan D. McCammon and Nicole M. Piemonte offer a thoughtful and thorough commentary on our manuscript entitled “Expanding the use of Continuous Sedation Until Death.” In this reply we attempt to clarify and further defend our position. We show how continuous sedation until death is not a “first resort” but rather a legitimate option among many that should available to terminally ill patients whose life expectancy is less than six months. We also attempt to show that we do not equivocate (...) the meaning of palliative care as the commentators suggested. We argue that the traditional notion of palliative care should move beyond relief of “experienced suffering” to relief of potential suffering for those whose life expectancy is less than six months. Lastly, we challenge the commentator’s position that the realm of ordinary medicine” should be the guide to care, by showing how the notion of ordinary medicine has been successfully challenged in both bioethical scholarship and the courts in a way that shows ordinary medicine to be an evolving concept rather than a static, universal guide. (shrink)

The Soviet Union's moderate and creative policy toward Africa's wars of liberation will go far in winning allies in the conflict of capitalistic and socialistic ideologies.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

People often choose intuitive rather than equally valid nonintuitive alternatives. The authors suggest that these intuitive biases arise because intuitions often spring to mind with subjective ease, and the subjective ease leads people to hold their intuitions with high confidence. An investigation of predictions against point spreads found that people predicted intuitive options more often than equally valid nonintuitive alternatives. Critically, though, this effect was largely determined by people's confidence in their intuitions. Across naturalistic, expert, and laboratory samples, against personally (...) determined point spreads, and even when intuitive confidence was manipulated by altering irrelevant aspects of the decision context, the authors found that decreasing intuitive confidence reduced or eliminated intuitive biases. These findings indicate that intuitive biases are not inevitable but rather predictably determined by contextual variables that affect intuitive confidence. (shrink)

This book reviews and integrates the most recent research and theories on this exciting topic, and features original contributions from leading researchers ...

This book is a comprehensive introduction to the many ethical and legal issues that arise in the practice of nursing. Ethical analysis is supplemented with the rigorous discussion of precedents from the American legal system as well as the requirements of professional codes operating at the national and state levels. Topics include informed consent, end-of-life treatment, impaired decisional capacity, privacy and confidentiality, and much more.

In order for a moral theory to support application it must be able to provide determinate answers to actual moral problems or, at the least, to significantly narrow acceptable options. It must also support the development of a genuine consensus, one that is disinterested, reasonable, and unbiased. I argue that theories concentrating on principles, or on rules, or on particular cases fail to meet these standards. A full coherence theory, taking into account principles, rules, practices, and judgments holds the greatest (...) promise for successful application. I present a detailed outline of a full coherence theory that is principled, pluralistic, and comprehensive. This coherence theory includes three basic principles (expressed both negatively and positively), but binds these, in terms of their explication and application, to rules and practices. This theory respects current practices but also directs us to change practices and institutions and even the interpretation of basic moral principles. The theory includes ways to determine which aspect of moral experience should take precedence in given circumstances, ways to determine who has particular obligations, and how — by means of a mutuality principle — value may be enhanced under conditions of value conflict. (shrink)